When the sciatic nerve, the longest nerve in your body, is impacted by muscle spasms or lower back challenges, the symptoms can radiate through your hips, legs, and back. Some common symptoms are numbness, weakness, tingling, and pain. Dr. Geoge Rappard can thoroughly evaluate the most appropriate treatment option to address your pain's cause and offer relief, including minimally invasive sciatica surgery in Los Angeles. Surgery is commonly recommended after conservative techniques fail.
Defining Sciatica
Sciatica is pain that affects the sciatic nerve, a nerve extending from the lower back down the back of every leg.
Generally, the pain affects only one side of your lower body. The pain extends from the lower back through the thigh’s back and down the leg. The pain can also extend to the toes or foot, depending on the location of the affected nerve.
While sciatica can be disabling and severe for some patients, the pain is irritating and infrequent but can worsen for others.
Common symptoms of this condition include:
- Hip pain.
- Lower back pain.
- Shooting pain that makes it difficult to stand up.
- Numbness, weakness, or challenges moving your foot or leg.
The pain can vary from mild to sharp, burning pain. Sometimes it can feel like an electric shock or jolt and can be worse whenever you sneeze, cough, or sit for long.
You should seek medical attention immediately if you experience any of the following:
- Back and fever pain.
- Redness or swelling in the spine or back.
- Pain that moves down the legs.
- Blood in the pee or a burning sensation whenever you pee.
- Severe pain.
- Weakness or numbness in your bottom, pelvis, upper thighs, or legs.
- Loss of bowel or bladder control.
Causes of Sciatica
Sciatica stems from irritation in the roots of the lumbosacral spine and lower lumbar.
Other causes of this pain include:
- Degenerative disk condition.
- Muscle spasms in your buttocks or back.
- Pregnancy.
- Spondylolisthesis.
- Lumbar spinal stenosis.
Other factors that increase the risk of suffering from sciatica include:
- Diabetes.
- Aging.
- Obesity.
- Putting on high heels.
- An occupation that involves twisting the back, lifting heavy things, or driving for extended durations.
- Smoking.
- Not exercising regularly.
How Sciatica is Diagnosed
If your physician believes you suffer from sciatica, they will perform a physical examination to check your reflexes and muscles’ strength. They can have you walk on your toes or heels to see the cause of the pain.
If the pain is severe, your sciatica surgery Los Angeles expert might order diagnostic tests to see herniated disks and bone spurs. These imaging tests can be:
- X-ray.
- Magnetic resonance imaging (MRI).
- CT scan.
- Electromyography (EMG).
Treatment: Purpose of Sciatic Surgery
Generally, sciatica surgery is not recommended unless non-invasive sciatica treatment in Los Angeles options like physical therapy, medication, and cortisone injections fail to relieve signs and symptoms. The healthcare provider can also suggest a surgical procedure if the pain worsens, you have weakness in the lower body muscles, or you have lost bowel or bladder control.
However, your sciatica surgery Los Angeles expert can recommend surgery as your first option if you suffer from:
- Cauda equina syndrome.
- Tumors.
- Bilateral sciatica.
- Infection in your pelvic area that fails to respond to medication.
Various Sciatica Surgery Los Angeles Options
Your surgeon can recommend different surgical procedures depending on the root cause of sciatica.
Lumbar Discectomy
A discectomy is performed to remove your herniated disc from your spinal cord. When your disc herniation happens, your spinal disc fragment is dislodged, pressing against nerves in your spinal cord. The pressure causes weakness, numbness, tingling, and electric shock pain.
The procedure is conducted under general anesthesia while the patient is lying face down with their back facing upwards. It can take up to one hour, depending on the patient’s size and the disc herniation degree.
The physician will make a tiny incision over your back’s center to remove your herniated disc fragment. Then the surgeon will carefully dissect muscles away from your spine bone. Using special equipment, the surgeon will remove ligament and bone from your spine, allowing them to see your spinal nerves.
After finding your disc herniation, your doctor will remove the herniated disc fragment. Depending on the condition and appearance of your remaining disc, more disc material can be removed to prevent future fragments. Finally, the doctor will clean the disc and close your incision.
Laminectomy Procedure
Laminectomy is another sciatica technique that involves removing tissues and bone spurs linked to arthritis of the spine, creating space. The surgical procedure enlarges the patient’s spinal cord, relieving pressure on nerves or the spinal cord.
Your doctor will administer general anesthesia so that you will be unconscious during your surgery. They will also monitor your blood oxygen level, heart rate, and blood pressure throughout the process.
Here is what to expect:
- First, your surgeon will make a tiny incision in the back over your vertebrae and move muscles away from the spine. The medical expert uses instruments to eliminate the least amount of lamina possible and bone spurs.
- If laminectomy is part of sciatica treatment for the herniated disc, your surgeon will also remove the herniated part of your disk and the broken loose pieces.
- If your vertebrae have slipped over another or for the curvature of your spine, your doctor might recommend spinal fusion to stabilize your spine. Spinal fusion permanently joins at least two vertebrae after removing your arthritic joints. The surgical procedure involves using bone grafts, screws, and metal rods.
Spinal Fusion
Like most sciatica surgical treatments, your physician will perform spinal fusion while you are unconscious. There are many ways to perform this surgical procedure. The technique your physician uses depends on the following:
- The reason for the surgery.
- The location of bones to be treated.
- Your overall health.
- Your body shape.
Here is what to expect during the procedure:
- Finding your spine — To locate the bones being fused, your physician will make an incision in one of three (3) places. from your back, the cuts are in the back or neck directly or on one side of your spine. The doctor will cut your throat or stomach to reach your spine from your front.
- Prepare your bone graft — Bone grafts originate from the patient’s pelvis or a bone bank. Sometimes the doctor can use artificial material instead of bone grafts. To get your bone, the physician will cut near your pelvic bone and remove a tiny piece before closing your cut.
- Fusion — To fuse your bones, your physician will place your bone graft materials between your bones. The medical practitioner can use metal rods, screws, or plates to hold your bones together as your bone graft recovers.
Potential Sciatica Surgery Risks and Complications
Surgery comes with complications, and spine surgery is no different. In your initial consultation with your doctor, ensure that you answer questions concerning your allergies, lifestyle choices, and medical history correctly; it will help reduce the risk of complications. Factors that can increase the risk for complications include age, overall health, osteoporosis, smoking, and prior smoking experience.
Common risks and complications include:
- Anesthesia risks — While these risks are rare, they are serious. They include heart attacks, brain damage, stroke, or even death. The complications can be due to medication reactions or issues originating from other health conditions.
- Bleeding — The technique surgeons use to make incisions and close the surgical wound is accurately performed to lessen blood loss. Nevertheless, injuries to major blood vessels can occur, causing bleeding.
- Blood clots — A patient undergoing sciatica surgery involving the lower extremities or the pelvis is at an increased risk of suffering from deep venous thrombosis (blood clots in the leg veins). Warning symptoms of possible blood clots include tenderness, swelling in your ankle, foot, or calf, and pain in the calf.
- Dual tear — A dual tear happens when the protective covering over your spinal nerves and spinal cord is torn during your sciatica treatment. Sometimes the physician can detect the tear during the surgical procedure and repair it. Generally, the tears recover without incident.
- Infections — The risk of infections after surgery is minimal. If an infection develops, it could only be in your skin incision or can spread to the area surrounding your vertebrae or spinal cord. Some symptoms of infections include fever, increased pain, a swollen wound, pus oozing from your incision, and a foul smell at your wound.
- Lung challenges — Inactivity, anesthesia, and pain medications after the surgery can affect your lungs. Therefore, it is recommended to cough and take frequent deep breaths often. Also, getting out of bed and upright in a chair allows your lungs to function better.
- Hardware fracture — Hardware (metal plates, rods, and screws) is used to align the vertebrae while the sciatica surgery heals. Before the patient fully recovers, the hardware can move from its position or break. It is known as hardware fracture. If this happens, the patient will require a corrective procedure to replace or remove the hardware.
Preparing for Sciatica Surgery Los Angeles
The more information you have about what to do on the days leading up to your surgery, the less anxious you are, increasing the possibility of better outcomes and accelerating your recovery.
Know the Location
Typically, sciatica treatment Los Angeles is performed in a hospital operating room. You should expect to be admitted for a couple of days. The length of your hospital stay will depend on your type of treatment.
What to Put On
The medical team will request you remove your clothing and change into a loose-fitting hospital gown. Therefore, leave your valuables at home and wear clothes that are easy to change.
After the surgical procedure, you might experience discomfort or soreness in the back. Consequently, it is recommended to carry loose-fitting clothes after your operation. Pants with a drawstring or elastic waistband and cotton T-shirts are ideal for seamless dressing. They are also comfortable.
Drinks and Food
It will help if you avoid drinking or eating eight hours before the scheduled operation to reduce the risk of complications. It includes all meals, beverages, water, alcohol, gum, mints, candies, and snacks.
Staying hydrated and eating healthy meals in the weeks and days leading up to the surgery will ease your healing process and reduce inflammation in the body .
Medications
It would be best to stop taking medications like blood thinners and non-steroidal anti-inflammatory drugs at least a week before the procedure to prevent anesthesia risks and excess bleeding. Always consult your doctor about supplements and medicines you are taking.
Pre-Operative Lifestyle Changes
You should stay active, quit smoking, and eat healthy meals to boost a smooth recovery. Prioritizing your emotional and mental health lowers body inflammation.
What to Carry
Items you require for sciatica surgery Los Angeles include:
- Insurance documentation.
- Comfortable clothes to change into following the operation.
- A type of identification like a passport or driver’s license.
Recovery Process
Following your surgery, your back will feel sore and stiff. You might also have challenges standing or sitting in one position for an extended duration. It will take about six weeks to return to performing simple activities like light house chores. It might take up to one year for your back to recover completely.
You can return to work within two months if your job does not require physical labor. However, patients whose jobs involved heavy labor cannot return to work after the sciatica treatment Los Angeles.
In order to promote spine recovery, your surgeon will also recommend physiotherapy and wearing a brace.
Below are more tips on how to take care of yourself at home:
- Walk daily.
- Avoid strenuous activities like jogging, bicycle riding, and weight lifting until the physician advises you otherwise.
- Drink a lot of water and eat normal foods. If your stomach is upset, eat low-fat foods.
- Take your medication as directed by the doctor.
- Follow the specific instructions given about caring for your incision. Your instructions will depend on the type of materials used to close the cut.
Contact a Skilled Surgery Near Me
If you suffer from devastating pain that does not respond to conventional sciatica treatment Los Angeles options, it is time to consider a surgical procedure. Dr. George Rappard can integrate their surgical skills with personalized care to safely alleviate the pain and assist you in regaining a healthy life. Please call the practice at 424-777-7463 to get answers to your questions and learn more.